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Adjuvant intratympanic steroid therapy in sudden sensorineural hearing loss
Sudden sensorineural hearing loss (SNHL) means abrupt hearing loss by 30dB affecting three consecutive frequencies within 72 hours. This is treated by high tapering doses of systemic steroids, the role of which is controversial and fraught with possible complications in...
Early DCR may be better than delayed in acute dacrocystitis?
Traditionally, acute dacrocystitis has been treated conservatively with antibiotics, analgesia and warm compresses, with surgery reserved for later when the infection has subsided. This meta-analysis looks at early vs. late endonasal dacrocystorhinostomy (DCR) in the treatment of acute dacrocystitis, looking...
Evidence for balloon eustachian tuboplasty
Balloon eustachian tuboplasty is an emerging intervention aimed at the management of eustachian tube dysfunction (ETD) and its sequelae. The authors acknowledge that ETD is a common but frequently ill-defined problem, with no well-established direct treatment. They performed a systematic...
Nasal peak inspiratory flow (NPIF) as a diagnostic tool for differentiating decongestable from structural nasal obstruction
Identification of the cause of nasal obstruction is critical before surgical intervention such as septoplasty. This study assesses changes in nasal peak inspiratory flow (NPIF) as a tool for discriminating decongestable versus structural obstruction. A cross-sectional study of 52 patients...
More aggressive FESS for recalcitrant CRS is the key
This is an interesting paper assessing the effectiveness of endoscopic modified medial maxillectomy (MMM) in cases of recalcitrant chronic rhinosinusitis (CRS), (the technique was also used for tumours, cystic fibrosis, FB, odontogenic disease and AFS) in 551 patients. The technique...
Antibiotics in orthognathic surgery
This paper from the Netherlands looked at 137 patients over a one-year period, 18 of whom had Le Fort I procedures, 68 bilateral sagittal split surgery, and 51 bi-maxillary surgery. A further 54 surgical procedures were undertaken, including 15 having...
Maxillomandibular advancement for sleep apnoea
This is a meta-analysis compiled from India. Of the initial 103 publications, 20 were analysed. Surgical cure was defined as postsurgical AHI of fewer than five events per hour. Of the 251 patients assessed for AHI, 12 were considered normal,...
QOL studies for anterior skull base surgeries
The Anterior Skull Base Nasal Inventory-12 (ASK Nasal-12) is a standard tool for assessment of quality of life (QOL) in patients who have undergone endonasal transsphenoidal surgery. As nasal trauma and rhinological complications following endonasal transsphenoidal surgery can influence QOL,...
Free flap reconstruction in stage three bisphosphonate-related osteonecrosis
There is no widely accepted gold standard for the treatment of bisphosphonate-related osteonecrosis of the jaw (BRONJ). Early BRONJ is managed conservatively but there is controversy regarding the treatment of the later stages. Stage three is defined as exposed bone...Targeted focal parathyroidectomy
Leanne Hamilton and Louise Clark describe their technique for helping to localise parathyoid adenomas. Surgically this can be difficult, so careful preoperative evaluation using imaging as described can help minimise difficulties intraoperatively when identifying the parathyroid adenoma. Preoperative imaging has...What is Transnasal Humidified Rapid-Insufflation Ventilatory Exchange (THRIVE)?
THRIVE is a physiological mechanism for oxygenating and ventilating patients who are under general anaesthesia and who have diminished or absent respiratory effort [1]. Classical ventilation requires bulk flow of gases into and out of the lungs driven by chest...
